Dear friends,
  I do recognise and respect the fact that for some moms feeding at breast is not an option due to all kinds of issues not primairily related to lactation. For those moms I am glad that the option to pump and bottle feed human milk is there. I would try, tho, to get them to work on the at-breast-feeding preventing issues in some way or another. 
  That said. I return to the question that raised (in my mind) in the begining of this discussion: why in the first place are women advised to pump to increase their milk supply? Is it not so that a baby at breast is a far more effective means of increasing a good enough milk supply? I professionally as well as personally think that asking a mother to feed at breast *and* pump *and* supplement her baby is way to much. Why not have mom feed baby more often instead of all extra pumping sessions? Why not advise mom to keep baby close to raise prolactin levels and be aware of any signal baby gives that shows readiness to nurse?
   
  Warmly,
   
  Gonneke, IBCLC, LLLL in warm-again soutern Netherlands 

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